Facility Evaluation Report, 01/12/2024 — San Benito House, Novato CA

At approximately 9:35AM Licensing Program Analyst (LPA) Helena Rummonds arrived unannounced to continue an annual required inspection and was greeted by staff. LPA and staff discussed the purpose of the visit. Administrator, Queen Ann Gougher arrived at approximately 10:30AM.

LPA reviewed 5 client files. Client files were observed to be in an unlocked cabinet accessible to clients. LPA reminded Administrator that client files are confidential and should not be accessible. LPA reviewed 5 staff files. Staff files were not immediately accessible as they are not stored physically on site. However, Manager of Program Operations, Kayla Hotchkiss, arrived at facility to assist LPA and was able to access files on their computer. Staff had required First Aid/CPR certificates. Per conversation with Manager of Program Operations, facility personnel are in the process of moving specific files into a binder to store on site for Community Care Licensing (CCL) to access whenever necessary. Last fire/ disaster drill was conducted 12/30/2023. LPA and Administrator reviewed client cash resources. LPA reviewed medications and medication records.

One of two carbon monoxide detectors that were tested was not operational during visit. Administrator discussed with LPA that the maintenance worker is scheduled to visit today and will be replacing it. Bathroom tile observed during visit dated 01/05/2024 has not yet been repaired. Per conversation with Administrator, facility is in the process of figuring out if they will have to update the entire bathroom or replace the tiles that have come off. Administrator stated that it is possible that when the bathroom was previously updated the floor did not get waterproofing underneath the tile, resulting in water damage. Facility is scheduled to have a general contractor come out on 01/13/2024 to inspect the tile and assess what action needs to be taken. Administrator to provide LPA with what information is provided during the assessment, as well as what action will be taken to repair tile.